social determinants
Social Science & Medicine 73 (2011) 50e59
Contents lists available at ScienceDirect
Social Science & Medicine journal homepage: www.elsevier.com/locate/socscimed
Comparing social determinants of self-rated health across the United States and Canada
Steven G. Prus*
Department of Sociology, Carleton University, D795 LA, 1125 Colonel By Drive, Ottawa, Ontario, K1S 5B6 Canada
a r t i c l e i n f o
a b s t r a c t
Article history:
Available online 18 May 2011
A large body of research shows that social determinants of health have significant impact on the health of
Canadians and Americans. Yet, very few studies have directly compared the extent to which social factors are associated with health in the two countries, in large part due to the historical lack of comparable cross-national data. This study examines differences in the effect of a wide-range of social determinants on self-rated health across the two populations using data explicitly designed to facilitate comparative health researchdJoint Canada/United States Survey of Health. The results show that: 1) sociodemographic and socioeconomic factors have substantial effects on health in each country, though the size of the effects tends to differdgender, nativity, and race are stronger predictors of health among Americans while the effects of age and marital status on health are much larger in Canada; the income gradient in health is steeper in Canada whereas the education gradient is steeper in the U.S.; 2) Socioeconomic status
(SES) mediates or links sociodemographic variables with health in both countriesdthe observed associations between gender, race, age, and marital status and health are considerably weakened after adjusting for SES; 3) psychosocial, behavioural risk and health care access factors are very strong determinants of health in each country, however being severely/morbidly obese, a smoker, or having low life satisfaction has a stronger negative effect on the
Contents lists available at ScienceDirect
Social Science & Medicine journal homepage: www.elsevier.com/locate/socscimed
Comparing social determinants of self-rated health across the United States and Canada
Steven G. Prus*
Department of Sociology, Carleton University, D795 LA, 1125 Colonel By Drive, Ottawa, Ontario, K1S 5B6 Canada
a r t i c l e i n f o
a b s t r a c t
Article history:
Available online 18 May 2011
A large body of research shows that social determinants of health have significant impact on the health of
Canadians and Americans. Yet, very few studies have directly compared the extent to which social factors are associated with health in the two countries, in large part due to the historical lack of comparable cross-national data. This study examines differences in the effect of a wide-range of social determinants on self-rated health across the two populations using data explicitly designed to facilitate comparative health researchdJoint Canada/United States Survey of Health. The results show that: 1) sociodemographic and socioeconomic factors have substantial effects on health in each country, though the size of the effects tends to differdgender, nativity, and race are stronger predictors of health among Americans while the effects of age and marital status on health are much larger in Canada; the income gradient in health is steeper in Canada whereas the education gradient is steeper in the U.S.; 2) Socioeconomic status
(SES) mediates or links sociodemographic variables with health in both countriesdthe observed associations between gender, race, age, and marital status and health are considerably weakened after adjusting for SES; 3) psychosocial, behavioural risk and health care access factors are very strong determinants of health in each country, however being severely/morbidly obese, a smoker, or having low life satisfaction has a stronger negative effect on the